Healthcare Provider Details

I. General information

NPI: 1669930079
Provider Name (Legal Business Name): ABBY HALPERN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2019
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4472 ELLIS CIR NW
CLEVELAND TN
37312-3326
US

IV. Provider business mailing address

830 W WOLFRAM ST
CHICAGO IL
60657-5108
US

V. Phone/Fax

Practice location:
  • Phone: 423-380-6263
  • Fax:
Mailing address:
  • Phone: 773-575-8557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number6445
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: